Legendary Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

LEGENDARY DENTAL PLLC

Practice address

1809 21St St
Harlan, IA 51537-1828

Phone

(712) 340-0333

NPI assigned

Jan 7, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Logan Travis Veath, DDS

Title

Dentist/Owner

Phone

(712) 340-0333

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1546819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546819200000",
    "number": "1114490778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 21ST ST",
            "city": "HARLAN",
            "state": "IA",
            "postal_code": "515371828",
            "telephone_number": "712-340-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 21ST ST",
            "city": "HARLAN",
            "state": "IA",
            "postal_code": "515371828",
            "telephone_number": "712-340-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGENDARY DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-07",
        "last_updated": "2019-01-07",
        "status": "A",
        "authorized_official_last_name": "VEATH",
        "authorized_official_first_name": "LOGAN",
        "authorized_official_middle_name": "TRAVIS",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "712-340-0333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366821183",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Marie Klein, RD, LD
• Joan Marie Kloewer, LBSW
• Lacey Kreisel, PHARMD
• June Landgren
• Leala Leaders
• Greg Leinen, PHARMD
• Wendy Jo Leinen, PTA
• Living Well Home Care LLC (Living Well Home Care)
• Markham Family Dental Associates, Inc.
• Phillip Lynn Markham, DDS

• General Practice Dentistry in Harlan, IA
• Providers in Harlan, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.